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This article appears in the Winter 2018 issue of The American Prospect magazine as part of a joint project with the Century Foundation on Health Reform 2020 . Subscribe here to The American Prospect . hc2020_logo-04_jpeg.jpg Imagine that you attend a country music concert or a quiet Texas church service, or are simply stopped at a local red light. In a flash, you are shot in the neck by a mass murderer. You wake up two days later in a hospital bed, a C45 quadriplegic. You will require home health-care aides, a $45,000 customized sip-and-puff electronic wheelchair, long-term services, and supports for the rest of your life. Such atrocities highlight massive defects in American gun policy. That part is obvious. Less obvious is how these atrocities also highlight massive defects in our health policies. Many of those disabled by gunfire will face a blizzard of medical bills and struggle to get needed services, rejoin the workforce, or ever resume a normal economic life. The next...

AP Photo/Lynne Sladky A Barett M107A1 rifle, left, is for sale at a gun show hosted by Florida Gun Shows, Saturday, January 9, 2016, in Miami. This article appears in the Winter 2016 issue of The American Prospect magazine . Subscribe here . Although recent rampage shootings have put gun violence back in the national spotlight, many people are convinced no practical measures can be taken. The poisonous politics of guns pose one set of obstacles. The sheer number of guns in private hands—310 million—creates another. Throw in current Supreme Court interpretation of the Second Amendment, and it’s easy to be pessimistic about the possibilities for making America safer. As great as immediate obstacles are, however, we do have the basis for a practical, medium-term agenda for limiting gun violence. I want to suggest three elements of such an agenda: controls of military-style weapons, regulations of gun purchases by people under age 25, and stronger penalties for illegal...

When I was a graduate student, abandoned houses were a real problem in my community. These eyesores blighted the neighborhood. In many cases, the city needed to quickly condemn these properties to address public safety concerns. Aldermen loudly complained about the cumbersome administrative process which produced a long waiting list of abandoned properties. I asked an expert why we couldn't fix this, and let the Mayor follow a fairer and more efficient process. "The aldermen would never allow that," he responded. They needed a decentralized, opaque, and inefficient process, which allowed them to perform visible constituency services, moving particular properties up the waiting list. It didn't hurt that the most powerful aldermen could provide the most valued services, too. To allow someone else--the Mayor, yet--to address these problems through an explicit, centralized process was a nonstarter. I remembered that story when I read Paul Krugman's nice op-ed yesterday. In defending the...

"Some politicians act like they love our constituents more than we do." So says Mississippi Gov. Haley Barbour. But it's hard to imagine "love for his constituents" being the first phrase that comes to mind when people think of Barbour, whose arguments in support of charging Medicaid recipients pharmaceutical co-payments included the nugget: "We have people pulling up at the pharmacy window in a BMW and say that they can't afford their co-payment." For anyone old enough to remember Ronald Reagan, Barbour's folksy account of Medicaid queens speaks for itself. Barbour made both comments at a governors' conference at which he argued states should have greater flexibility to trim Medicaid benefits and eligibility. To put it mildly, Mississippi is not the ideal state for Republicans to argue the supposed merits of local control in public assistance and health policy. This is a state that sets its maximum monthly welfare benefit for a family of three at $170. This is also a state that has...

Scientist John Sulston announcing the completion of the mapping of the human genome in 2001. (AP Photo/Adam Butler)

When my children were born in the mid-1990s, new parents could already see that prenatal genetic testing was altering the terrain of pregnancy and childbirth. Growing numbers of educated women were having children at older ages, with resulting difficulties and risks. More and more parents faced challenging, deeply personal decisions about whether to engage in genetic testing and what to do if they received unfavorable results. I remember my own anxieties when my wife, Veronica, took a blood test that searched for elevated alpha-fetoproteins, which are associated with diverse ailments ranging from spina bifida to anencephaly. The mere prospect of these rare conditions -- and even the choice to undergo the tests -- was surprisingly painful. At least genetic counselors and other professionals were available to help guide us. By that point, amniocentesis had been in wide use for more than two decades. As researchers identified the genetic markers associated with a growing list of...